M.E.Müller: Atlas: Fracture 33-A3

Femur, Distal,
extra-articular fracture,
metaphyseal complex 0,43% of the total
0,72% of the femur
12,15% of the segment

30 fractures
12,7% group
33%M, 67%F

69 fractures
29,1% group
49%M, 51%F

138 fractures
58,2% group
52%M, 48%F

With an intermediate split fragment Irregular, limited to metaphysis Irregular, extending into diaphysis

These are extra-articular fractures of the distal femur, metaphyseal, multifragmentary, complex and irregular, extending to the diaphysis. Ref. Manual of Internal Fixation:
216 - 217. 548 - 552.
Surgeon. RO.

These are very serious fractures and their treatment is very difficult. The treatment principles are the same than the ones stated for the two previous groups, A1 and A2. The difference is that the reduction of the multiple intermediate fragments must not be attempted. With the knee flexed 90º and adequate traction the fragments are brought together next to the plate. Axial tension should not be applied to the plate, which functions as a buttress plate in these cases.

The illustrated case is exceptional and it is shown in order to demonstrate the usefulness of the condylar plate along with methyl-metacrylate in fractures on very osteoporotic bone. This patient was an 85 year old female, carrier of a bilateral hip prosthesis, that suffered a running over accident resulting in a bilateral supracondylar fracture. The condylar plate screws allow better fixation into the osteoporotic condyles than the 95º angled condylar blade plate. The use of methyl-metacrylate gives immediate stability to the fracture and allows early mobilization of the elderly patient. In this case, the patient survived two years with a good quality of life.

preoperative preoperative

postoperative postoperative postoperative




						Femur, Distal, extra-articular fracture, metaphyseal complex	0,43% of the total 0,72% of the femur 12,15% of the segment






These are extra-articular fractures of the distal femur, metaphyseal, multifragmentary, complex and irregular, extending to the diaphysis.		Ref. Manual of Internal Fixation: 216 - 217. 548 - 552. Surgeon. RO.

These are very serious fractures and their treatment is very difficult. The treatment principles are the same than the ones stated for the two previous groups, A1 and A2. The difference is that the reduction of the multiple intermediate fragments must not be attempted. With the knee flexed 90º and adequate traction the fragments are brought together next to the plate. Axial tension should not be applied to the plate, which functions as a buttress plate in these cases.	The illustrated case is exceptional and it is shown in order to demonstrate the usefulness of the condylar plate along with methyl-metacrylate in fractures on very osteoporotic bone. This patient was an 85 year old female, carrier of a bilateral hip prosthesis, that suffered a running over accident resulting in a bilateral supracondylar fracture. The condylar plate screws allow better fixation into the osteoporotic condyles than the 95º angled condylar blade plate. The use of methyl-metacrylate gives immediate stability to the fracture and allows early mobilization of the elderly patient. In this case, the patient survived two years with a good quality of life.